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What are the causes of diarrhea and vomiting illnesses?
These illnesses can be caused by infectious diseases, changes in diet, and the use of some medications. Infectious diseases
can be caused by viruses, bacteria or parasites. Some examples include:
• Viruses: norovirus, rotaviruses, enteric adenoviruses, astroviruses, caliciviruses
• Bacteria: Shigella, Salmonella, Campylobacter, some types of Escherichia coli, Clostridium difficile
• Parasites: Giardia, Cryptosporidium
What other symptoms may happen?
Besides diarrhea and vomiting, people may have blood in their stools, abdominal cramps, abdominal tenderness, fever,
and/or generally feeling unwell.
How are these illnesses spread?
• Germs are spread by people who do not wash their hands after they use the bathroom, especially if they have diarrhea.
Their unclean hands can spread germs to others through food preparation or on objects that they’ve touched.
• Germs can be found on areas near where someone has recently vomited.
• Sometimes unclean food or water may have germs that can cause diarrhea or vomiting.
• Sometimes these germs can be spread in unclean swimming pools, hot tubs, fountains, lakes, rivers, springs or streams.
• People can still spread the germs to others when they are recovering from an illness.
Who is at risk for these illnesses?
People of all ages are susceptible to the viruses, bacteria and parasites that cause diarrhea or vomiting. Depending on the
specific cause, complications are more likely to occur in children younger than five, in the elderly, or in people with
compromised immune systems.
What can be done to prevent diarrheal illnesses in school settings?
• Use good hand hygiene habits such as washing with warm water and soap for 15-20 seconds. This is the only way to
effectively remove substances from soiled hands.
• Students and staff should thoroughly wash hands after using the restrooms and before handling food for themselves or
others. Adults should remind children about appropriate hand hygiene.
• Alcohol-based hand gels reduce the amount of germs on hands but do not remove dirt. Alcohol-based hand gels may
not be effective for some viruses, so when in doubt, use soap and water.
• Vomiting or diarrheal illness should be reported to the school nurse office or designee immediately.
• People at school who become ill with vomiting or diarrhea should be separated from others while waiting to go home.
• Schools should ensure that there are adequate supplies of soap and paper towels for hand washing.
• Schools may consider use of alcohol-based hand hygiene products to be used when hands are visibly clean in areas such
as the cafeteria and classroom.
When can students or others return to school?
• Anyone with diarrhea or vomiting should remain at home until he/she has recovered from these symptoms for at least 24
hours, without the use of medication.
Prevention of Diarrhea and Vomiting
Illnesses in Schools
Public Health
Fact Sheet
Public Health
Fact Sheet
10/2010
For further information call or visit us on the World Wide Web
Acute Disease Service
Oklahoma State Department of Health
Phone (405) 271-4060
http://ads.health.ok.gov

What are the causes of diarrhea and vomiting illnesses?
These illnesses can be caused by infectious diseases, changes in diet, and the use of some medications. Infectious diseases
can be caused by viruses, bacteria or parasites. Some examples include:
• Viruses: norovirus, rotaviruses, enteric adenoviruses, astroviruses, caliciviruses
• Bacteria: Shigella, Salmonella, Campylobacter, some types of Escherichia coli, Clostridium difficile
• Parasites: Giardia, Cryptosporidium
What other symptoms may happen?
Besides diarrhea and vomiting, people may have blood in their stools, abdominal cramps, abdominal tenderness, fever,
and/or generally feeling unwell.
How are these illnesses spread?
• Germs are spread by people who do not wash their hands after they use the bathroom, especially if they have diarrhea.
Their unclean hands can spread germs to others through food preparation or on objects that they’ve touched.
• Germs can be found on areas near where someone has recently vomited.
• Sometimes unclean food or water may have germs that can cause diarrhea or vomiting.
• Sometimes these germs can be spread in unclean swimming pools, hot tubs, fountains, lakes, rivers, springs or streams.
• People can still spread the germs to others when they are recovering from an illness.
Who is at risk for these illnesses?
People of all ages are susceptible to the viruses, bacteria and parasites that cause diarrhea or vomiting. Depending on the
specific cause, complications are more likely to occur in children younger than five, in the elderly, or in people with
compromised immune systems.
What can be done to prevent diarrheal illnesses in school settings?
• Use good hand hygiene habits such as washing with warm water and soap for 15-20 seconds. This is the only way to
effectively remove substances from soiled hands.
• Students and staff should thoroughly wash hands after using the restrooms and before handling food for themselves or
others. Adults should remind children about appropriate hand hygiene.
• Alcohol-based hand gels reduce the amount of germs on hands but do not remove dirt. Alcohol-based hand gels may
not be effective for some viruses, so when in doubt, use soap and water.
• Vomiting or diarrheal illness should be reported to the school nurse office or designee immediately.
• People at school who become ill with vomiting or diarrhea should be separated from others while waiting to go home.
• Schools should ensure that there are adequate supplies of soap and paper towels for hand washing.
• Schools may consider use of alcohol-based hand hygiene products to be used when hands are visibly clean in areas such
as the cafeteria and classroom.
When can students or others return to school?
• Anyone with diarrhea or vomiting should remain at home until he/she has recovered from these symptoms for at least 24
hours, without the use of medication.
Prevention of Diarrhea and Vomiting
Illnesses in Schools
Public Health
Fact Sheet
Public Health
Fact Sheet
10/2010
For further information call or visit us on the World Wide Web
Acute Disease Service
Oklahoma State Department of Health
Phone (405) 271-4060
http://ads.health.ok.gov